Friday, April 14, 2006

Patterns of global tobacco use in young people and implications for future chronic disease burden in adults

The Lancet:
CW Warren a , NR Jones a, MP Eriksen b and S Asma a, for the Global Tobacco Surveillance System (GTSS) collaborative group
"Summary
Background
Tobacco use is a leading preventable risk factor for many chronic disorders, which are expected to account for an increasing share of the global disease burden. As part of the Global Youth Tobacco Survey (GYTS), we aimed to assess the effect of tobacco use by young people on global mortality. Methods
GYTS is a school-based survey of students aged 13–15 years. The survey was undertaken at 395 sites in 131 countries and the Gaza Strip and West Bank. We questioned students about current tobacco use, susceptibility to smoking among non-smokers, and exposure to secondhand smoke at home and in public places.
Findings
The difference in current cigarette smoking between boys and girls is narrower than expected in many regions of the world. Use of tobacco products other than cigarettes by students is as high as cigarette smoking in many regions. Almost one in five never-smokers reported they were susceptible to smoking in the next year. Student exposure to secondhand smoke was high both at home (more than four in ten) and in public places (more than five in ten). Never-smokers were significantly less likely than current smokers to be exposed to secondhand smoke at home (prevalence 39·1% [95% CI 36·6–41·6] vs 72·8% [64·0–81·6]) and in public places (49·5% [46·7–52·3] vs 81·2% [74·2–88·2]).
Interpretation
Our findings are troubling for the future of chronic disease and tobacco-related mortality. Reduction of tobacco consumption will require a redoubling of efforts to prevent initiation and promote cessation among the large proportion of young people who currently use tobacco. High exposure to secondhand smoke suggests a need for countries to pass strong and effective smoke-free policies./.../"

Thursday, April 13, 2006

Chromosome 17 Identified as Site for Drug Dependence Genes - CME Teaching Brief - MedPage Today

Chromosome 17 Identified as Site for Drug Dependence Genes - CME Teaching Brief - MedPage Today: "NEW HAVEN, Conn., April 12 - Researchers are one step closer to finding genes involved in drug addiction, including dependence on opioid drugs such as heroin, morphine, and OxyContin (oxycodone).
Two clusters of such genes appear to be hiding out on chromosome 17, according to a genetic linkage study conducted by Joel Gelernter, M.D., of Yale, and colleagues, published in the May issue of the American Journal of Human Genetics. "

Monday, April 10, 2006

"Anti-Tobacco Industry Plan" (PM, 1996 est.)

"Anti-Tobacco Industry Plan" (PM, 1996 est.):Anti-Tobacco Industry Plan
Document Date: 1996 (est.)Length: 15 pagesBates No.: 2063393705/3719
URL of this Posting: http://tobaccodocuments.org/...Document images: http://legacy.library.ucsf.edu/...

This Philip Morris (PM) presentation describes a comprehensive, long term plan by PM to divide the ranks of tobacco control groups and weaken their efforts to reduce tobacco use. Public health authorities, groups and individuals who work to reduce smoking are known collectively inside PM as the "anti-tobacco industry," (ATI, or "antis" for short). PM regarded them as competitors seeking to take away market share. PM's "Anti-Tobacco Industry Plan" was devised by Joshua ("Josh") Slavitt, Director of Policy and Programs at PM Management Corporation. Slavitt was considered PM's internal expert on "the antis" and their strategies.
Part of PM's plan was to cause dissent among to tobacco control groups by "enhancing internal conflicts" among them. To carry out this strategy, PM sought what it considered "moderate" anti-tobacco groups, and worked to enter into relationships with them and get them to work with the company in some cooperative capacity. Another strategy was to "limit or redirect" public health funding away from tobacco control programs PM didn't like, and direct it to programs PM approved of (that didn't harm cigarette sales or the image of smoking) like "youth education, preventing youth access, etc." PM also worked to stimulate financial investigations of public health groups to weaken them and "challenge their so-called 'white hat' image with elected officials and the media."
PM estimated that it would cost $500,000 to carry out the program for the first year.
This document discloses that PM actively engaged in a comprehensive, long-term effort to undermine tobacco control programs, sought to increase in-fighting among tobacco control groups by allying with selected groups, and worked politically to divert funding dedicated from effective tobacco control programs to causes that the company considered benign to their long term interests.
Quotes:
Anti-Tobacco Industry Plan
We have spent considerable time discussing the importance of developing a response to the anti's. We like to call them the Anti-Tobacco Industry because they have the economic and political resources to deserve to be called an industry.
• Today, I'd like to present you with a plan that will coordinate company and external resources to diminish the effectiveness of the Anti-Tobacco Industry.
• Our plan also seeks to moderate the ATI's impact on the policy process so that we can reestablish our credibility through the initiatives that we are developing.
• After we have implemented these initiatives we must continue to keep pressure on the ATI so that we can restore and maintain balance in the political process and with the media.
• Just as importantly, we need a plan with obtainable goals and performance measurements that can be tracked over time.
Strategies
There are four strategies to our plan. We want to:
1) Limit public funding sources available to the ATI --ultimately make the ATI more accountable for both the private and public sources of revenue that its members receive.
2) Weaken the ATI's credibility by challenging their so-called "white hat" image with elected officials and the media.
3) Put the ATI on the defensive to enhance internal conflicts and cause divisions among its leadership regarding strategies and tactics --this is a natural outgrowth of our first and second strategies.
4) Conduct a comprehensive competitive intelligence effort on the ATI to better understand its strategies and long-term goals --just as we would address any other business adversary.
Let me discuss our fourth strategy first.
Strategy 1: Intensify Research
-Competitive intelligence is the bedrock of any successful business effort. We must view our effort to respond to the ATI the same way. We want to:
1) Identify and learn about the makeup of the ATI's leaders and organizations.
2) Identify emerging trends, issues and strategies.
3) Analyze their potential vulnerabilities and ours as a result of their activities.
-Information we gather will be warehoused in a database which we call Common Ground.
-Competitive intelligence on the ATI is integral to our plan because it enables us to prioritize our near-term and longer-term strategies.
-Competitive intelligence also gives us the opportunity to develop proactive and offensive responses to the ATI --this is critical to our ability to put them on the defensive as we restore balance in the debate over our issues.
[From Page --3710]:
Strategy 2: Limit Funding
Our second strategy focuses on limiting funding available to the ATI. We want to identify opportunities to:
1) Limit or redirect federal and state funding. However,to do this,we also need to first decide what types of anti-tobacco programs are acceptable to us, e.g. youth education, public advertising campaigns, preventing youth access, etc.
2) In order to accomplish this effort, we will have to highlight waste and abuses in publicly funded programs. Our primary focus will be on legislators, but we'll also have to generate media stories in order to reinforce this message.
3) We already know that the ATI receives a minimum of $600 million a year from public and private sources. This is hardly small change at a time when a number of social activists are competing for a shrinking pool of public funding.
The ATI has reached the level of funding where they should be considered fair game by other social activists--if these other activists knew just how much the ATI was receiving. Naturally,we want to make this information available. However, we also want to identify the right groups to provide this information.
[From Page --3716]:
Strategy 4: Divide Ranks
Our Fourth Strategy focuses on efforts to cause dissention within the ATI.
1) As the tobacco company that is seeking "reasonable solutions to complex problems" we want to reach out to members of the ATI where we can potentially establish Common Ground--such as on the issue of preventing youth access to tobacco products.
Strategy 4 Process Measurements:
For 1997,we will:
1) Complete the process of comparing the company's positions with anti-tobacco control advocates.
2) We also want to see a measurable increase in the number of legislators at the federal, state and local levels who publicly endorse AAA and our Federal Initiative.
3) When we've made measurable advances on these two steps, we will then reach out to groups and individuals where Common Ground is possible. Combined with our advances on our second and third strategies, we have an opportunity to increase pressure on the ATI, which can be used to cause additional divisions within the ATI.
--We expect, that as their funding is squeezed and investigations are launched on potential violations of state and local lobbying laws, some ATI advocates may think pragmatically about accepting our offer to work together to address the youth issue as well as other issues where we can arrive at a consensus.
This effort will cause further dissention between those anti groups that seek prohibition at any cost and those who are truly concerned about achieving reasonable solutions...
2) We also want to enhance internal conflicts that already exist within the ATI --and possibly encourage some new ones.

Saturday, April 08, 2006

Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study -- Houston et al., 10.1136/

Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study -- Houston et al., 10.1136/bmj.38779.584028.55 -- BMJ: "Results Median age at baseline was 25, 55% of participants were women, and 50% were African-American. During follow-up, 16.7% of participants developed glucose intolerance. A graded association existed between smoking exposure and the development of glucose intolerance. The 15 year incidence of glucose intolerance was highest among smokers (21.8%), followed by never smokers with passive smoke exposure (17.2%), and then previous smokers (14.4%); it was lowest for never smokers with no passive smoke exposure (11.5%). Current smokers (hazard ratio 1.65, 95% confidence interval 1.27 to 2.13) and never smokers with passive smoke exposure (1.35, 1.06 to 1.71) remained at higher risk than never smokers without passive smoke exposure after adjustment for multiple baseline sociodemographic, biological, and behavioural factors, but risk in previous smokers was similar to that in never smokers without passive smoke exposure."